As if on cue, various members of the left are getting themselves all worked up over the GOP’s new platform. ThinkProgress published a short piece, written by Ian Millhiser, warning that the “GOP platform declares Medicaid unconstitutional.” But this really need not concern progressives, since the party platforms are nothing more than formal campaign promises, they mean nothing in reality.
The platforms, for all of the drama and parliamentary bickering that goes into forming them, function only to spark fires under the party’s base. The more noteworthy portions of the platforms, such as the one about Medicaid, will no doubt be red meat for self-described fiscal conservatives and advocates for limited government. Tea Partiers will surely be happy to see such additions and may be more inclined to vote for Romney/Ryan if such language is included in the written part of the campaign.
Sadly though, for anyone who takes the 10th Amendment seriously, who would prefer a return to federalism, such changes are unlikely to come from the GOP. The spirit of this limit on federal power is too often left with the trampled confetti and withering balloons after election day celebrations. If it’s not thrown out completely come inauguration day, the platform is long forgotten, wadded up with the campaign banners and leftover bumper stickers. The only chance it has to see the light of day is when some party intern pulls it from the closet four years later and gets it ready for another hollow convention.
But this isn’t the only reason the progressive left needn’t worry that Mitt Romney is going end Medicaid. In the GOP’s attempt to placate the Ron Paul Republicans, it seems they drafted a rather week plank on the subject, upon closer examination. It reads in part:
We support the review and examination of all federal agencies to eliminate wasteful spending, operational inefficiencies, or abuse of power to determine whether they are performing functions that are better performed by the States. […] We affirm that all legislation, rules, and regulations must conform and public servants must adhere to the U.S. Constitution, as originally intended by the Framers. […] We propose wherever feasible to leave resources where they originate: in the homes and neighborhoods of the taxpayers (emphasis added).
First, any document written for the purpose of rolling back the federal government (that isn’t just a lame attempt at pandering) should do more than review and examine federal waste and abuse. Anyone paying attention knows that all federal programs are rife with waste and abuse – that’s all government programs are!
Second, if a return to constitutional government is really the goal, then it should be well-understood that questions of government are to be made strictly on the letter of the law, not on which agency is better able to perform them. As it stands, the constitution gives no authority to the federal government – none at all – to provide any health services, with perhaps the care of the military as the only exception.
And as for the third point, wherever feasible is the perfect clause from which to renege on the promise of conforming to the constitution. All some committee, special council, or other group has to do is conclude that it wouldn’t be feasible to relinquish state power. Given the massive bureaucracy and entrenched culture of centralized power in Washington D.C., who really expects a GOP administration to carry on with some Jeffersonian overhaul? No one grounded in reality, that’s for sure.
Setting aside the GOP’s infidelity to their platform, and the semantic tricks they play, this debate is still an important one to have. We’re not going to achieve a federal rollback – or even get moving in that direction – without having this debate and winning over a substantial group to tip the balance in our favor. So, for the sake of argument, here is the case for rolling back entitlements and returning to a more decentralized approach.
Millhiser is getting all hot under the collar because he’s afraid the GOP platform fits too closely with a lawsuit challenging the Affordable Care Act. Were this suit to overturn certain provisions of “Obamacare,” he fears it could jeopardize other federal programs, including Medicaid. If Medicaid were to be permanently repealed, argues Millhiser, then 62 million Americans would lose their health coverage.
Though Millhiser doesn’t make the explicit claim here, he alludes to an argument that others on the left frequently rely on: the Affordable Care Act must be constitutional; otherwise it would follow that other federal programs, such as Medicare, would be unconstitutional as well. The question begged here is that national healthcare programs – of any stripe – are themselves in accordance with legitimately-delegated powers. Even a cursory reading of Article 1, Section 8 reveals that no such authority was delegated to the federal government, but this hasn’t prevented the Feds from administering a host of programs they were never authorized to undertake.
Given the situation with entitlement spending Millhiser and others on the Left have no cause for alarm. The GOP is being propped up electorally in large part by a group dependent on Social Security and Medicare, so those programs won’t see voluntary cuts even if Republicans sweep the November elections. Remember, it was a Republican House, Senate, and President that expanded Medicare the last time they had control. No, if any of those programs are to be cut it will be part of an overall default, and no one will be able to control that.
And despite all their rhetoric about Obama being the “food stamp president,” he is so in large part because of the Republicans, who allowed expansions of the program to occur during the Bush Years. The Right is no more opposed to welfare, in practice, than the Left is to war. Don’t think so? Then ask why we aren’t living in a libertarian paradise by now, what with the supposed “antiwar radicalism of Obama and the laissez faire anarchism of Bush,” as Anthony Gregory recently quipped, tongue planted squarely in his cheek.
But returning to Millhiser’s concern over welfare recipients, if we could return to a constitutionally-compliant government, would they be without health coverage? Maybe, but that doesn’t mean they would be without healthcare – there is a difference. Before the federal government became so involved in the medical industry a thriving market existed, which catered to all social strata, such that no significant difference in quality or quantity of medical care existed between wealthy patients or those living in poverty.
Joshua Fulton, writing for the Ludwig von Mises Institute, explains how mutual aid societies provided these crucial services: “Mutual aid was particularly popular among the poor and the working class. For instance, in New York City in 1909 40 percent of families earning less than $1,000 a year, little more than the “living wage,” had members who were in mutual-aid societies.” He continues, noting that membership in lodges offered many with access to affordable life insurance, as well as disability and health coverage.
Under lodge medicine, the price for healthcare was low. Members typically paid $2, about a day’s wage, to have yearly access to a doctor’s care (minor surgery was frequently included in this fee). Non–lodge members typically paid about $2 every doctor’s visit during this time period.
The reason such mutual aid societies and private social systems aren’t in place, and why prices have ballooned almost beyond comprehension, is because of those very government programs championed by Millhiser and other apologists for the state. Fulton explains how politically-connected competitors colluded with governments to push out the private network of charities and free-market health providers, thus providing the pretext for ever-more intervention into the industry. The very notion of a private, voluntary system is practically unheard of, and demonstrates one symptom of a government-run society that Thomas Woods describes in his book Rollback, namely that government intervention discourages imagination and innovation.
So not only is it the case that Republicans won’t end Medicaid, since there is nothing in their platform or party history to indicate such aims, but supposing they did, it would be a boon for the poor and needy. Once again they could enjoy quality care that was readily available, while everyone – rich and poor – would be free to live their lives without a parasitic class (politicians, bureaucrats, rent-seeking corporatists, and the like) living on the backs of the populace. To this end it is vital we reject the false dichotomy presented by the Left and Right, and nullify those who would force us to live in the dystopian nightmares that are the fantasies of central planners and sycophants.